Higher blood pressure in seven-year-olds is associated with an increased risk of death from premature cardiovascular disease decades later, a research letter published in JAMA suggests.

The study of 37,000 children, with a median follow-up of 54 years, included comparisons between siblings to limit the confounding effect of family lifestyle, the US researchers said.

“The findings underscore the importance of early-life cardiovascular health promotion, with a focus on monitoring and modifying blood pressure-associated risk beginning as early as age seven,” said the team, led by the Northwestern University Feinberg School of Medicine in Illinois.

Blood pressure at seven was recorded once, between 1959 and 1965, before researchers followed up on the cause of death for participants who had died during or before 2016.